Sorry it's been so long folks. It's been kind of hectic here, and without internet access at home, and work being busy, well, unfortunately, the blogging kind of falls by the wayside. But, OMG, there is so much going on. I'm sure you know most of it, but let's go over it in any case.

Pop Culture:4 Months, 3 Weeks and 2 Days - an award winning film - was reviewed by the NYT recently. It was a critic's choice film. And, you know, it won the Palm D'Or a while ago. There's still a lot of discussion about Knocked Up/Juno where unplanned pregnancy seems to be something that, well, all works out in the end. Laura Sessions Stepp, who I know many of you don't really like (article topics include hook-up culture and gray rape) wrote an article in the Post pointing out the dangers of being a teen mom.

Maria and I talk about this all the time, because I'm not so keen on the idea of teenagers having kids, and she thinks we need a more supportive community for helping pregnant teens. I don't think it's a great idea, in part because teen pregnancy is the number one indicator of future poverty. This, of course, gets us into teen sex, about which the NYT published an article in January. The article focuses on the emotional impact of sex on teen girls, as well as pregnancy. Good read. Oh, and I'm not getting into this right now, but there was a big to-do over these Denver girls who want maternity leave from high school.

Love:So there was that big TIME Magazine section on love, and it was Valentine's Day yesterday (I got my sweetie these) and so love is in the air. Researchers have shown that people in love don't really check out other potential mates, but they do check out potential rivals. Sadly, sometimes love doesn't work out. When the engagement gets called off there is a developing field of law in who gets what damages, as well as some etiquette on who gets the ring.

Birth Control:There is a new label on the birth control patch. Women who use Ortho-Evra, the patch, are at increased risk of blood clots. The risk is still pretty small, but it's much higher than for women using the pill. Talk to your doctor.

Barr, a maker of generic birth control pills, has filed a patent infringement suit against other pharmaceutical companies over oral contraceptives.

Ireland lowered the condom tax. A 12-pack of condoms costs about E13; they cost about $12 here in the States. I get the impression from the BBC article, by the way, that in some places condoms are free under the country's medical plan.

Washington State has tabled a bill that would require pharmacists to dispense Plan B, or the Morning After Pill. Issues related to conscience clauses loom large in this debate, and it appears that the legislature is going to pitch this over to the court system first. South Dakota, on the other hand, is trying to make sure that pharmacy refusal clauses don't allow pharmacists to refuse to dispense birth control pills.

Sexually Transmitted Infections (Including HPV):There's a journal article on expedited partner therapy, which is when the partner of someone who's positive for an STD gets a prescription/treatment for the STD without clinical assessment (e.g. your boyfriend gets treated for chlamydia if you test positive, without testing him.) I can't access the article, but the intro says that the CDC recommends EPT, which may raise some legal concerns. I would love to see a copy of the article if anyone has it.

New Pap test - the SoftPAP - approved by the FDA. This test apparently decreases the number of false negatives given by using the traditional (or ThinPrep?) Pap test. Currently it is recommended that women get a Pap test and an HPV test.

A new study shows that 1/3 of women with one sexual partner contract HPV in a year. So I'm just remembering these numbers offhand, but I recall that over 26 million American women have HPV, and only 10,000 cases of cervical cancer are reported per year. Further, only 3,000 women die of cervical cancer. So this mechanism of HPV infection --> cancer is not at all a one-to-one ratio. Anyway, I guess my point is that HPV is really common, and cervical cancer isn't. And while this isn't news to readers, who well know that HPV causes more than just cervical cancer, somehow it's news again that HPV causes oral cancers.

STDs common in Australian Aborigines. The article kind of reminds me of "The Tipping Point" chapter on STDs in as it states that when a population has >10% infection rate it's worth treating everyone with antibiotics to fight infections.

This week was not only MLK Day, but Roe v. Wade Day. Additionally, I lost another family member to cancer. In any case, there was a lot you should have read about:

Roe v. Wade Day/Abortion:Frances Kissling (formerly of CFFC) and Kate Michelman (formerly of NARAL) wrote an op-ed in the LA Times about abortion, and, really, the shift in perception around abortion. They say that one thing the pro-choice folks need to engage in is a discussion about the "challenges" of the movement, including the judgment of women for getting pregnant in the first place.

Saletan says that pro-choicers need to message abortion with the goal of zero, same as teen pregnancy.

Reproducing:Related to the LA Times op-ed, a study out about Indiana shows that about 80% of black babies are born to unwed mothers. Single mothers have lower levels of education and higher rates of poverty than married mothers, although that doesn't necessarily include those older single moms.

Italy has ruled that it is now legal to do pre-implantation genetic diagnosis of embryos. The ruling, applicable only to the Rome area, will be reviewed by a higher court. Also, don't forget, that in Italy only 3 embryos can be implanted at a time.

So while feminism opened up options for a lot of women, there was an ensuing backlash against feminism, and now there's this embrace of everything under the sun as feminism. Want to walk around with a dog collar being led by your boyfriend? Who's to say that's not feminist? Stripping? Feminist. Housewife? Totally feminist (not by all). I'm not about to make any statements about it right now, but it certainly seems to be a trend that the idea of "choice" whether related to feminism or abortion, is in the eye of the beholder. I mean, is one's choice really off bounds for social comment?

Science:The Pill has an extended effect on preventing ovarian cancer, the number one cause of gynecologic cancer deaths in the United States. Apparently, this is leading folks in the U.K. to renew a call to make the Pill available over-the-counter. Additionally, caffeine decreases the risk of ovarian cancer, while alcohol and tobacco use play no role in it.

As always, there's way more to blog about, but I have to get moving. Have a great weekend!

Reproductive Rights:So, I guess this comes as a surprise, but women who have abortions think about the kind of life they could provide for a child, and the lives they want to provide for their existing children. I'm not sure how I feel about this report. I think it's still in that vein of "abortion is a hard decision" and tries to un-demonize women who have abortions.

I can't find the original article, but a letter to the editor in a Massachusetts newspaper criticizes a man whose girlfriends had four abortion for his "conversion" to anti-choice advocacy. The author writes that the man should have been responsible then, not now, and includes being responsible to mean sticking around. The author seems to imply that if men would stay with women more, they would continue their pregnancies, which I'm not so sure about. I do, however, agree that anti-choice advocates could emphasize the role of men in unplanned pregnancy as much as the abortion itself.

Kentucky is considering a bill that would require women seeking abortions to have an ultrasound. At my old clinic, every woman had an ultrasound, at the least, to measure fetal size/age. I would think that's important for knowledge of the type of abortion needed, the amount of drugs, etc. But I also am not a doctor, so I don't know. Nor is Senator Jack Westwood, so I don't know why he's bringing this up.

For information on what it's really like to be an abortion doctor, read "This Common Secret: My Journey as an Abortion Doctor" by two doctors from Montana.

In other state news, Tennessee is thinking about amending its Constitution to shrink abortion rights. The Constitution has been interpreted to provide greater abortion rights than the U.S. Constitution, and therefore invalidated a law requiring a waiting period. The amendment would read that nothing in the Tennessee Constitution protects a right to abortion.

The American College of Ob-Gyns has released a new ethics opinion on doctor refusals, calling for limits on conscientious refusals, especially those that impose religious or moral beliefs, or are not scientifically based.

Science & Health:Following a Mediterranean diet when pregnant lowers the risk for the babies to have asthma. That could be better worded, but it's not.

I'm reading this book called The Humble Little Condom, and I'm learning a little more about syphilis, which, apparently, Christopher Columbus brought back to Europe with him. The New World syphilis wasn't fatal, I guess, but it mutated somewhere along the way to a potentially deadly disease.

Generally, we know that young college-educated women are waiting to have children, and, often putting less emphasis on romantic relationships. Additionally, the idea that couples in love must get married is no longer a given, as almost half of Americans say they don't need a marriage certificate to prove their love. The Post writes about those who aren't waiting to have kids - but these are still women in their late 20s. My friend RJ & I wonder if the model of college/graduate school/marriage/family really works for women. We're in our 30s by the time we're having kids, with fertility issues, less energy, and a body that doesn't bounce back as easily. I wonder if the college/marriage/family/graduate school model wouldn't be better?

It's a new year, and a new legislative session, not to mention that a whole bunch of laws go into effect this week.

As for me, I'm getting over a cold which had me on the couch watching the History Channel's marathon The History of Sex, which has a few errors in it, but was overall an enjoyable quick tour through the ages. My New Year's resolution is to cut out dairy, and start eating more organic food.

So anyway, what do you need to know for this upcoming year? First, vote (make sure you are registered to vote in your state). Today are the Iowa Caucuses, then the New Hampshire primaries, and February 5th is Super Tuesday. Do I really have to tell you what's at stake (like, Roe)?

So let's talk about local laws:

Virginia will hear about increased penalties for domestic violence offenders and repealing the requirement that women take lie detector tests when they report a rape.

We'll see more about jurisprudence for civilians serving overseas, as more stories like this one come to light. Congressman Poe's office tells me that the Military Extraterritorial Jurisdiction Act is the law on the books that would cover this, but many others have said the law is too narrowly crafted to create any kind of legal punishment.

The Times reviews a book on a fertility diet, and not very favorably. I guess people are more interested in fertility, as it seems birth rates are on the rise in the US. The article says that more affluent people are having more children, and calls children a luxury good. I'd be curious to see more about the rates related to income, and if the US has a higher rate of fertility than many other industrialized nations because of our immigration policies.

Schizophrenia may start in utero, and may be linked to maternal diseases like the flu.

ForeignTeen will have access to birth control over the counter in Britain. Meanwhile, South Africa is taking the opposite tactic, and outlawing teens kissing in public. (The actual law, all 80 pages of it, is here as a .pdf. I didn't read it, so I don't know the exact language used.)

You all, I'm sure, have been following the rape case in Saudi Arabia. Slate asks why there isn't more of an uproar over how Saudi (and many other countries) treat women, generally. The article references the huge boycotts of South Africa regarding its policy of apartheid.

Cancer News:The National Breast Cancer Coalition, which has worked hard to get federal funds for breast cancer research, has launched a site with video and text from Presidential candidates regarding their intended role in fighting breast cancer. The group also recently released a survey on breast cancer awareness. I'm shocked at how little people know about this common and detectable disease. For something like ovarian cancer, I'm not surprised (although I'm not happy) at how little people know. Illinois has expanded its breast an cervical cancer screening program, funded through the National Breast and Cervical Cancer Screening Program. People should really know about this, because what use is knowledge of the symptoms of breast or cervical cancer, without a way to actually treat it?

A subset of cancer news: HPVGov. Schwarzenegger vetoed a bill that would have required some health insurance plans to cover the HPV vaccine. Via RHRealityCheck, Denmark and the UK recommend that all girls get the HPV vaccine. Did we already discuss this? The HPV test is more useful at finding cancer than a Pap test - at least the version of the Pap test researchers used, which is not the same one used in the US. (Again, I'll note that my boyfriend works for the company that has the only FDA approved HPV test in the United States, as a full disclaimer).

Domestic:Speaking of Illinois, apparently the pharmacy refusal clause issue has reached a settlement. The Post reports "Trained technicians or store owners would contact a pharmacist at
another location, then follow his or her directions for dispensing the
morning-after pill."

Birth control at middle school? There are very few 11 to 13 year olds having sex, but those that do are hopefully making informed choices, and need access to safe and effective contraceptives. But wow, 13...does that sound young to anyone, or am I getting old?

India:Two Indian news stories, a country for which I have a special place in my heart. First, unwanted sex common among married women in India. Second, GE says it is willing to do more to reduce the use of ultrasound machines for determining a fetus' sex. It is illegal to use an ultrasound for that purpose in India due to the high rate of sex-selective abortions. Nonetheless, it is possible to get around this law, as is the case with most laws. Especially in developing countries. I did a fair amount of work on rule of law stuff, especially as it relates to human rights in developing countries, which is why I am eternally amused by the man from Ghana who wanted me to ignore Ohio's 24 waiting period for abortion, and give his wife an abortion that day, promising me that he wouldn't tell anyone. Anyway, another story on India is the lack of affordable sanitary pads for menstruation.

Fertility:Low birth weight babies born in the NYC area around 9/11 due to stress. New birth control, for women, of course, and years away. Egg freezing not the number one choice, as the odds aren't fabulous that the egg will survive. Embryos and sperm, as we've discussed, fare much better. Chinese herbs useful for menstrual pain. Kroger offers some Pills for $4.

I just got back from a women's health morning roundtable with a number of women's health groups, but not the ones you would expect. And while I'm mulling over what we've talked about, I see that the role of women in Saudi life is being re-opened. So what was interesting in this morning session was that two women from two different organizations made statements that really rubbed me the wrong way.

First, it appears that the American Heart Association is going to do research on abortion and heart health. I can't find any literature on the topic, so maybe investigation is called for, but maybe not. In fact, a magazine passed around at the meeting said that the incidence of heart attack in pregnant women and women in labor is on the rise. This may not be due to pregnancy itself being more dangerous, but that more women have health issues like diabetes and high blood pressure that lead to heart attacks.

Second, someone started talking about framing women's health in terms of preconception health care, which made me so mad my voice was shaking. I told the group that in my opinion, it wasn't really appropriate to frame all women's health with respect to their ability to reproduce, for a number of reasons, not the least of which is that women's health should be primarily about the woman. More of women being vessels.

So yes, smoking is bad for fetal development, but it's bad for women, and should smoking cessation focus on pregnant women? For sure! Should we tell women never to smoke because one day they might want to have a baby? Absurd.

Addicts can be rational, as Gary Becker explains, when they believe that the cost of their addiction, including withdrawal, is less than the benefit they derive from engaging in the addictive behavior. For example, many economists have postulated that smoking by young poor people is completely rational given their overall life expectancy. And we see, of course, that in the United States, the poor have higher smoking rates than the rich.

The young woman who smokes has already taken into account the risk smoking will play on her fertility. She may have greatly discounted it, but that's her personal calculus. To change the weight upon which she places on her future fertility means that we discount her as a person, and value more the potential life that may or may not be a part of her body one day. That's not to say that women shouldn't be counselled about their fertility, and what steps they can take to increase or maintain their fertility, but isn't that part of a large decision making process that necessarily includes contraception and abortion, as well as good personal decision making? And that is predicated on respect - not as a vessel, but as a person within one's own right.

Am I making any sense? I didn't really want to get into it at the conference, but I'm still annoyed.

I'm moving this weekend! It's chaos around here, and doing this news round up helps me clean out my inbox. Which, you know, probably shouldn't be my first priority, but other cleaning involves getting up, and buying boxes and whatnot. And I'm not moving until...tomorrow...Anyway, here goes:

Babies:Now, I know we talked a while ago about this Russian day of procreation, and it's been all over the news this week! Slate has a nice round up on what countries are doing with regards to procreation and population - what kind of economic or other policies can a government implement to encourage or discourage procreations? The Beeb covered this a few months ago, which you may have read about on this blog.

In the U.S., high Latino birth rates are the main component of Latino population growth (rather than immigration). "Nationally, Johnson calculates, there are seven Latino births for every
death, compared with 1.3 white births for every death."

Gender:The Post has a compelling piece about gender in South Asia. This closely mirrors the recent Slate piece on how television is helping to empower women in rural India. The Post story is about a girl in Bangladesh who is being pressured to get married at age 13. She is the star of a TV show in which her character is urged to either drop out of school and work, or drop out of school and marry. Gender issues in South Asia are incredibly complicated, and sex-selective abortions are rampant. So rampant, in fact, that India banned the use of prenatal ultrasound for sex identification. There are still lots of ads for that service, as anyone who's driven down a street in New Delhi can tell you.

Gender discrimination suit alleges, among other things, that women were denied promotions and better accounts because they refused to take part in such "business activities" as visiting strip clubs.

And I know we just talked about this whole stay at home husband/gender roles thing, but here it is again, in New York Magazine. "Well into feminism’s second generation, there are finally a significant
number of women reaching parity with the men in their fields—not to
mention surpassing them—and winning the salary, bonuses, and perks that
signify their arrival...In 2001, for example, wives earned more than
their spouses in almost a third of married households where the wife
worked. Yet this proud professional achievement often seems to have
unhappy consequences at home...Indeed, there’s little evidence to show that as women acquire financial
muscle, relations between the sexes have evolved successfully to
accommodate the new balance of power. Neither the newly liberated alpha
women nor their shell-shocked beta spouses seem comfortable with the
role reversal." Just read the article

Law:The New Jersey Supreme Court ruled this week that a doctor has no duty to tell an abortion patient that the fetus/embryo is a person. If you read this story you'll see why terminology is so important (am I a broken record, or what?) A nurse referred to "the baby" when the embryo was only 6 weeks. Dictionaries define baby as birth to one year, although many refer to "the baby" when having an abortion. It's a hard concept to grasp, I'll grant you that, but one that I think should be made clear. In my old clinic we decided to use whatever terminology the woman was most comfortable with, and using the word "baby" always made me uncomfortable. Regardless, informed consent is an important part of medical care, and I'm not sure the doctor's assertion that the fetus was "just blood" was an accurate statement either. In any case, the plaintiff alleged that the doctor failed to inform her that the fetus was a human being with whom she had an existing relationship (why the doctor would be the one to tell her about her relationships is beyond me) and the court sided with the doctor. This biased counseling thing is fairly widespread, and getting worse.

And the animal story: Salmon spawn trout in genetic experiment. As a picky grammar note, young fish are not called "babies." I know it's a complicated point, that not everything has to be anthropomorphized, but let's try?

Obesity --> truancy --> teen pregnancy. I would think that obesity may also be related to teen pregnancies for other reasons. One, girls who are fatter develop earlier, as estrogen is fat-soluble. They are then physically more mature without having the accompanying mental maturity. Two, social issues regarding being fat and being liked. Third, behavioral issues that may have induced poor eating habits (bad decision making) or lack of impulse control I could easily see also leading to bad decision making or lack of impulse control when it comes to sex. But I'm just speculating here. Anyone know?

So I'm moderately obsessed with this issue, and I'm really glad that a study shows that women with lupus have higher rates of cervical cancer (that's kind of what it says). I mean, it makes total sense that women with autoimmune diseases couldn't fight off HPV as well as others, and that they would have higher rates of abnormal paps and cervical cancer. Right, and I've been talking about this for a few years, and saying that women with autoimmune diseases may need different screening for cervical cancer than the average woman, and maybe they should just be tested for HPV and if the test is positive then do a pap more often and I don't know exactly what my treatment protocol suggestion is, but I'm psyched regardless.

Feministe appears to be down right now, but there was this great catch they made about the mainstream press not correcting some anti's assertion that birth control doesn't work, among other falsehoods.

The New York Times asks: Is there anything good about men? Mostly, it goes on to say that men take risks to be chosen for reproduction, and that women don't because they need to stay home to take care of the babies and they're pretty much assured reproduction (and survival of their genetics).

Sanitary pad lawsuit. This goes back to something from the other day about skipping periods, etc, and I dug around a bit and there's apparently not a whole lot of data on historical sales of menstrual products, and even if there were I bet a lot of stuff that was used was not sold and wouldn't be captured in that data, and that as these products became more of a market item the use of the Pill was burgeoning, and women were having more menstrual cycles b/c they weren't having children as often, so I don't think there's any data on periods that I want.

Washington State pharmacists are suing over a state regulation that, shockingly, requires them to dispense drugs. Of course, it's the morning after pill, but since the pill is behind the counter, and has to be dispensed by a pharmacist, um, the pharmacists are going to have to DISPENSE THE PILLS. Seriously, get another job if you don't want to hand out medication. I, for example, never am asked for medication all day. Not once. Okay, maybe if someone has a headache. But there are tons of jobs that don't requiring handing out pills. Unfortunatly, "pharmacist" isn't one of them.

Women taking accutane are still getting pregnant. I took this drug many years ago, and I had to be on the pill, have monthly pregnancy tests, sign something saying I understood that I was not to get pregnant and that the fetus would be all messed up and I should probably have an abortion, AND, each pill had a cardboard picture over each foil blister pack with the profile of a pregnant woman and a big red line through it.

Oh my: induced...miscarriage? abortion? "gloopity glop"? In any case, it'll be an interesting legal case, as the MD law being used to hold the woman has an exception for women whose behavior harms their own fetuses, as do most "fetal homicide" laws. The woman also had two more dead fetuses in her house.